Improving the prescribing practice of junior doctors through interprofessional collaboration and evidence-based education.

The last decade (2010-2019) has seen calls to action to improve the prescribing practice of junior doctors. An in-depth investigation into the causes of prescribing errors by foundation trainees in relation to their medical education (the EQUIP study) in the UK reported a prescription error rate of 8.9% for all prescribed medicines, and although that is a UK study, there are similarities with New Zealand prevocational training programmes. The EQUIP study revealed that existing teaching strategies are not working. To believe a single intervention will prevent most prescribing errors is simplistic, and for improvement to occur, new prescribers need to learn from their mistakes. Traditionally, the education of junior doctors has focused on their competence and professional registration requirements. Working in healthcare is collective and multidisciplinary, and errors occur through human and system factors.

Medicine Administration in People with Parkinson's Disease in New Zealand: An Interprofessional, Stakeholder-Driven Online Survey.

Medicine administration errors are twice as frequent in people with dysphagia than in those without. Medicine administration is particularly critical for people with Parkinson's disease where late, or missed doses reduce medicine effectiveness and impact on the quality of life. The aim of this study was to explore the current medicine administration practices of people with Parkinson's disease in New Zealand. A self-administered online survey was developed by an interprofessional group including people with Parkinson's disease (the primary stakeholders), speech-language pathologists and pharmacists. The survey was administered using a cross-sectional study design and asked respondents about self-reported swallowing difficulties [using Eating Assessment Tool (EAT-10)], medicine regimes and strategies used to swallow medicines. Seventy-one people with Parkinson's disease responded to the survey (69% male, mean age 72 years, mean years with Parkinson's disease 9 years). Respondents reported complex daily multi-medicine consumption (mean no. of pills 11, range 2-25). Analyses showed that 57% of respondents scored outside the normal range for EAT-10 (> 3) with 57% complaining of difficulties with pills. Many respondents admitted to missing medicines and requiring external reminders. Multiple strategies for swallowing pills were described including crushing tablets, using yoghurt or fruit juice, and swallowing strategies (such as head tilt, effortful swallow, chin down and altered pill placement in the mouth). Medicine administration is complex and challenging for people with Parkinson's disease. The development of educational packages for people with Parkinson's disease, their carers and health professionals is much needed.